Finerenone exposure and ischaemic stroke in patients with type 2 diabetes and chronic kidney disease: A propensity score-matched cohort study.

IF 3.9 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Clinical Medicine Pub Date : 2026-08-06 DOI:10.1016/j.clinme.2026.100617

Wu-Lung Chuang, Ruey-Hwang Chou, Yuan-Hung Wang, I-Ju Tsai, Cheng-Li Lin, Der-Yang Cho, Kuang-Hsi Chang

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引用次数: 0

Abstract

Background: Type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) commonly coexist and are associated with an increased risk of ischaemic stroke. Finerenone has demonstrated benefits on composite renal and cardiovascular outcomes in randomised trials; however, ischaemic stroke has generally been evaluated as part of composite endpoints, and real-world evidence focusing on this outcome remains limited.

Methods: We conducted a retrospective cohort study using the TriNetX Global Research Network to evaluate the association between finerenone use and incident ischaemic stroke among adults with newly diagnosed T2DM who subsequently developed CKD. Finerenone users were compared with non-users. Propensity score matching was applied to balance demographic characteristics and baseline comorbidities. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results: A total of 125,086 eligible patients were identified before matching, including 1,990 finerenone users. After 1:1 propensity score matching, 1,990 finerenone users were matched with 1,990 non-users with adequate covariate balance. Finerenone use was associated with a lower observed hazard of ischaemic stroke both before matching (adjusted HR, 0.30; 95% CI, 0.24-0.36) and after matching (adjusted HR, 0.33; 95% CI, 0.26-0.42).

Conclusions: In this real-world cohort of patients with T2DM and CKD, finerenone use was associated with a lower observed hazard of ischaemic stroke.

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芬烯酮暴露与2型糖尿病和慢性肾病患者缺血性卒中：一项倾向评分匹配的队列研究

背景：2型糖尿病（T2DM）和慢性肾脏疾病（CKD）通常共存，并与缺血性卒中的风险增加相关。在随机试验中，芬尼酮已被证明对肾脏和心血管综合预后有益处；然而，缺血性卒中通常被评估为复合终点的一部分，关注这一结果的真实证据仍然有限。方法：我们使用TriNetX全球研究网络进行了一项回顾性队列研究，以评估在新诊断为T2DM并随后发展为CKD的成人中使用芬尼酮与缺血性卒中发生率之间的关系。芬烯酮服用者与非服用者进行比较。倾向评分匹配用于平衡人口统计学特征和基线合并症。采用Cox比例风险模型估计95%置信区间的风险比（hr）。结果：匹配前共确定了125086例符合条件的患者，其中1990例为细芬烯酮使用者。经1:1倾向评分匹配后，1990名细芬酮使用者与1990名非使用者匹配，协变量平衡充分。芬尼酮的使用与匹配前（校正HR， 0.30; 95% CI, 0.24-0.36）和匹配后（校正HR， 0.33; 95% CI, 0.26-0.42）观察到的缺血性卒中风险较低相关。结论：在这个现实世界的T2DM和CKD患者队列中，使用细芬烯酮与观察到的较低的缺血性卒中风险相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Medicine 医学-医学：内科

CiteScore

7.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Medicine is aimed at practising physicians in the UK and overseas and has relevance to all those managing or working within the healthcare sector. Available in print and online, the journal seeks to encourage high standards of medical care by promoting good clinical practice through original research, review and comment. The journal also includes a dedicated continuing medical education (CME) section in each issue. This presents the latest advances in a chosen specialty, with self-assessment questions at the end of each topic enabling CPD accreditation to be acquired. ISSN: 1470-2118 E-ISSN: 1473-4893 Frequency: 6 issues per year